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Individual

DR. FREDESWINDA POLICARPIO CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4 GADSEN PLACE, STATEN ISLAND, NY 10314
(718) 698-3333
(718) 698-2691
Mailing address
4 GADSEN PLACE, STATEN ISLAND, NY 10314
(718) 698-3333
(718) 698-2691

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MA023641
NJ
208000000X
Pediatrics Physician
Primary
106163
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0052638
GHI
NY
01
62872
EMPIRE BLUE CROSS BLUE SH
NY
Enumeration date
10/01/2007
Last updated
10/01/2007
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